Scottish Executive

Ambulance Service

Rob Gibson (Highlands and Islands) (SNP): To ask the Scottish Executive when the single-crewing of ambulances will end.

Mr Andy Kerr: Where the Scottish Ambulance Service assesses that an area should be served by an accident and emergency unit, then a double crewed unit is what should be provided. There may be occasions where, for example, a member of staff reports sick at short notice and the Service is unable to secure a relief member. In these circumstances a single-crewed unit may be used. Such cases should only arise in the most exceptional of circumstances. The Scottish Ambulance Service has been made aware that the Executive expects to see service improvement delivered to urban and rural areas of Scotland in equal measure and that there should be a reduction in the number of occasions when a single crewed ambulance is dispatched.

Dentistry

Alasdair Morgan (South of Scotland) (SNP): To ask the Scottish Executive what statistics it maintains on waiting times for dental treatment.

Mr Andy Kerr: Information Services Division collects waiting time information for dental treatment at consultant level only. Waiting times are recorded for a first outpatient appointment following general medical/dental practitioner referral and the waiting time recorded for consultant services for the period from being placed on the inpatient and day case waiting list to admission for treatment. Information is not collected centrally for waiting times for dental treatment undertaken in hospital at a second or subsequent outpatient appointment.

  Information is collected centrally on waiting times for in-patient or day-case treatment in hospital in all dental specialties.

Disability Discrimination Act 1995

Ms Sandra White (Glasgow) (SNP): To ask the Scottish Executive what monitoring or guidelines exist to ensure compliance by building managers with the Disability Discrimination Act 1995 in respect of disabled access to public buildings.

Malcolm Chisholm: The Disability Discrimination Act (DDA) 1995 is reserved to Westminster and the UK Government.

  The DDA makes no provision for a system of inspection to enforce ‘compliance’ with the Act. Instead, where an individual considers that they have been discriminated against, they may initiate an action against the service provider on the grounds of said discrimination.

  The Disability Rights Commission (DRC) was established by the UK Government in 2000 to "eliminate the discrimination faced by disabled people and promote equality of opportunity". In relation to the DDA it has a role in providing guidance and assistance to disabled people, service providers and employers and can bring legal cases to enforce and clarify the law.

  The DRC also publishes codes of practices to assist employers and service providers in the understanding and execution of their duties under the act and have revised the current code of practice on Access to Goods, Services, Facilities and Premises to reflect the DDA provisions which came into force on the 1 October this year.

Health

Christine Grahame (South of Scotland) (SNP): To ask the Scottish Executive what the average post-operative survival rate has been for patients undergoing a (a) heart-lung, (b) heart and (c) lung transplant in each year since 1999.

Mr Andy Kerr: Because of the small numbers involved, and on grounds of patient confidentiality, it is not possible to provide the information in the form requested specifically for patients in Scotland.

  The 1 year transplant survival estimates following heart-lung transplants in the UK between 1999 and 2002 is set out in the following table:

  

Transplant Type
Number in Analysis
% Survival


Heart/lungs
128
68.7%


Heart
737
82.1%


Lung(s)
394
79.9%



  Source: UK Transplant

Health

Mr Stewart Maxwell (West of Scotland) (SNP): To ask the Scottish Executive what the haemophilius influenza type B invasive disease incidence was per 100,000 head of population in each year since 1999, calculated on the same basis as the World Health Organization’s European health for all database.

Mr Stewart Maxwell (West of Scotland) (SNP): To ask the Scottish Executive what the total number of cigarettes consumed was in million pieces per year in each year since 1999, calculated on the same basis as the World Health Organization’s European health for all database.

Mr Andy Kerr: I refer the member to the answer to question S2W-10305 answered on 22 September 2004. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at http://www.scottish.parliament.uk/webapp/wa.search .

Health

Christine Grahame (South of Scotland) (SNP): To ask the Scottish Executive, further to the answer to question S2W-10193 by Malcolm Chisholm on 28 September 2004, whether it will list (a) information that has previously been provided by the Scottish Key Indicators Package for Performance (SKIPPER) which is not currently duplicated in some form on the ISD website and (b) information that has previously been provided by SKIPPER that it does not plan to make available on the web.

Andy Kerr: The information published in SKIPPER was split into 11 broad groups each of which contained a variety of analyses as listed in the table below. The tables below show the definition of each category of analysis, whether it is currently available from another source and relevant comments. The final release of SKIPPER includes details of alternative sources of information available on the ISD website.

  ISD continually work with all stakeholders across NHSScotland to ensure the information published is relevant and accurate, undertaking reviews as necessary.

  The only areas where ISD has made a decision not to provide the information on the website are where the SKIPPER presentation no longer reflected the organisational structure of NHSScotland, or where improved information is already available on the web site.

  Detailed tables, by topic, are shown on the following pages.

  Activity

  

Category of Analysis
Currently Available
Comments


NHS BOARDS
 
 


Deprivation Category -Inpatients, Outpatients Treated
No
There is deprivation information available on specific topic areas on the web site, for example, http://www.show.scot.nhs.uk/publications/isd/deprivation_and_health/


Discharge Rates by Principal Diagnosis
No
Discharge Information is available on specific topic areas.


Discharge Rates by Principal Operation Procedure
Yes
Only numbers (not rates) on web. Breakdown by board not available.


Inpatient, Day Case Episodes - SMR01
Yes
Less detail available. Figures on web not shown at specialty level.


Specialty: NHS Board Residents by Trust of Treatment
No
Acute activity information on the web is currently under review.


Specialty: Discharge Rates & New OP Appointment Rates
Yes
Only numbers (not rates) on web.
Less detail available. Figures on web not shown at specialty level.


Hospital Activity - ISD(S)1
No
Scottish figures on acute activity website for beds and quarterly inpatients & day cases & outpatients by NHS Board.
Information on web under review – plans to increase information available on web.


Day Patient Activity: HB Comparison
No
Scottish figures on mental health area.
Information on web under review – plans to increase information available on web.


Professions Allied to Medicine (PAMs) (now known as Allied Health Professionals) : HB Comparison
No
Community PAMs (now known as Allied Health Professionals) on data development area.
Information on web under review – plans to increase information available on web.



  

NHS TRUSTS
Trust level data for the following categories were produced on SKIPPER but, as Trusts no longer exist, data are no longer produced at this level. Some of the categories are produced at Health Board level.


Average Length of Stay Distribution
 
 


Case Mix Adjusted - Average Length of Stay
 
 


Case Mix Adjusted - Day Case Rate
 
 


Day Case Procedures
 
Presented at NHS Board level not Trust on the web.


Deprivation Category -Inpatients, Outpatients Treated
 
 


Geriatric Long Stay - Hospital Admissions 
 
 


Hospital Activity - ISD(S)1
 
See notes for ISD(S) 1 under NHS Board. (previous section)


Inpatient, Day Case Episodes - SMR01
 
Less detailed organisation breakdown available on the web.


Non Attendance Rates - New Outpatient Appointments
 
Less detail available on the web. At Scotland and specialty level only.


Non Attendance Rates - Specialty Mix Adjusted
 
 


Obstetric Episodes - SMR02
 
 



  Cancer

  

Breast Screening Uptake
Yes
Although not exactly the same – only percentages are provided.


Cervical Screening
Yes
Only for target age group – no age breakdown supplied.


Standardised Incidence Ratios
Yes
General incidence & mortality information available. Level may vary.


Standardised Mortality Rate
Yes
General incidence & mortality information available. Level may vary.


Survival Rates
Yes
General survival information available. Level may vary.



  Child Health

  

Accidents to Children - Emergency Admissions to Hospital
Yes
Level of information presented will vary


Breast Fed Babies
Yes
Information might vary slightly


Children Free from Dental Caries
No
Current data are held by DHSRU. There is a link to their website from the ISD website.


Childhood Mortality
Yes
No board breakdown on the web but probably available from GROS


Immunisations
Yes
 


Infant Mortality Rate
Yes
Information presented may vary slightly but in general information is available on the web.


Teenage Pregnancy
Yes
 



  Clinical Outcomes - this information is available on the clinical governance website:

  Clinical Outcomes Indicators December 2000 report

  

Standardised % First Births by Caesarean Section
Yes
Tables were not updated every year in SKIPPER.  


First Delivery by Caesarean Section Second Delivery Vaginal
Yes

Tables were not updated every year in SKIPPER.  


Live Births Admitted to Neonatal Unit
Yes
Tables were not updated every year in SKIPPER.  


Termination of Pregnancy at <=9 weeks by Medical Methods
Yes
Tables were not updated every year in SKIPPER.  



  Finance

  

NHS Board
 
 


NHS Board Management Costs per Head of Population
No
Data no longer available due to a change in Board annual accounts.


Expenditure by Head of Population
Yes
 


Trust – Provision of Healthcare Expenditure
 
 


Total Expenditure – All Services
Yes
 


Acute Services 
Yes
 


Maternity Services 
Geriatric Assessment Services 
Yes
 


General Psychiatry Services
Yes
 


Learning Disabilities Services
Yes
 


Geriatric Continuing Care Services
Yes
 


Younger Physically Disabled Services
Yes
 


Other Community Services
Yes
 


Family Health Services 
Yes
 


Hospital
 
 


Hospital Running Costs
Yes
 



  Heart Disease

  

Directly Standardised Mortality Rate - HB Comparison
Yes
Will be available on updated CHD website release on 29th October 2004


Discharge Rates by Principal Diagnosis
Yes
Will be available on updated CHD website release on 29th October 2004


Operation Procedures - HB Comparison
Yes
Will be available on updated CHD website release on 29th October 2004


Procedures Within 2 Years of Emergency Admission 
No
May be added to future updates of the Coronary Heart Disease (CHD) website



  Mental Health

  

Admissions by Diagnosis
Yes
Some information available but for discharges rather than admissions and not at the same level of detail (only broad diagnostic groups – hidden in the age/sex breakdown category!). The most recent year for which we have complete data on psychiatric admissions and discharges for all health boards is 2001 This is because of data extraction problems due to the introduction of new computer systems.


Admissions - Learning Disabilities
No
 


Admissions by NHS Board of Residence by Trust of Treatment
Yes
Some information available but not at the same level of detail.(available for NHS board of residence but not trust of treatment)


Continuous Morbidity Recording (CMR) - GP Consultation Rates
Yes
GP consultation, incidence and prevalence rates for depression and anxiety for 2003, available at: www.isdscotland.org/isd/general_practice_info


Discharges from Hospital
Yes
Some information available but not at the same level of detail (destination on discharge; discharges by NHS board/local authority of residence; by diagnosis group) 


Standardised Admission Rates by NHS Board
No
 


Suicides - Years of Life Lost by Age Group
No
 



  Primary Care Services

  

Dental
 
 


Number of General Dental Practitioners (GDPs) per 1000 population
Yes
Is currently available on web (as number of GDPs per 100,000 population, at 31/3/2004), but is not likely to be updated more than once per year.


Patients Registered with a GDP by Age Group
Yes
Is currently available on web (at 31 December 2002 and 31 March 2003), but is not likely to be updated more than once per year.


Medical
 
 


Continuous Morbidity Recording 
(CMR) - GP Consultation Rates (annual)
Yes
GP consultation rates by age and sex for 2000 - 2003, available at:
www.isdscotland.org/isd/general_practice_info


GPs per 1000 Practice Population
No
Will probably be added to the web – after accessing stakeholder demand for information.


GP Practice Average List Size (Trust / Local Health Care Cooperative (LHCC)
Yes
Level of information presented may vary on the web.


GP Practice Populations (Trust / LHCC) 
Yes
Information presented at NHS Board level on the web.


Prescribing
 
 


Expenditure(£) – Trust / LHCC Comparison
No
Monthly reports are sent to interested parties (HBs and GPs).


Prescriptions & Ingredient Cost – Trust Comparison
Yes
Scotland level only, but a greater level of information available on the web.



  Public Health

  

Births
 
 


Births by Maternal Age 
Yes
 


Live Births by Gestation & Weight Group
Yes
 


Communicable Diseases
 
 


Notifiable Disease Rates
Yes
 


Genito Urinary Medicine - New Patients Seen by Age Group
Yes
 


Mortality Rates
 
 


Mortality Targets - Year 2010
Yes
Information on performance against targets is available on the Performance Assessment Framework (PAF)
PAF link


Directly Standardised Rates NHS Board Comparison 
No
Standardised mortality Information is available on specific topic areas.


Years of Life Lost NHS Board Comparison
No
Information is available on life expectancy and healthy life expectancy on the GROS and ISD web sites.


Populations
 
 


Estimates - NHS Board Annual Trend
Yes
On GROS website


Projection - NHS Board Annual Trend
Yes
On GROS website


Deprivation Categories - HB Comparison
Yes
There is deprivation information available on specific topic areas on the web site, for example, http://www.show.scot.nhs.uk/publications/isd/deprivation_and_health/



  Waiting Times

  

NHS Board
 
 


Inpatients, Day Cases on Waiting List
Yes
Level of presentation different


Inpatients, Day Cases Treated - Time Waited
Yes
Level of presentation different


Deferred Inpatient Day Case Waiting List
No
The deferred waiting list was abolished on 1st April 2003 it is therefore not possible to update this information any more. See more detailed note below table.


Outpatients by Time Waited
Yes
Level of presentation different


Trust
 
 


Inpatients, Day Cases on Waiting List
Yes
Level of presentation different


Inpatients, Day Cases Treated Time Waited 
Yes
Level of presentation different


Deferred Inpatient Day Case Waiting List
No
The deferred waiting list was abolished on 1st April 2003 it is therefore not possible to update this information any more. See more detailed note below table.


Outpatients by Time Waited 
Yes
Level of presentation different


Accident & Emergency
 
 


Accident & Emergency Waiting Times
Yes
Distribution of times may vary



  Changes arising from the abolition of the Deferred Waiting List (DWL)

  The Scottish Executive advised NHSScotland that the DWL would be abolished on 1 April 2003. In order to meet this commitment NHS Trusts have been required to carry out a review of patients on the deferred waiting list in the period up to that date.

  Following review, these patients will either be:

  added to the true waiting list and assigned an appropriate Availability Status Code (ASC). In such cases the patients will be included in the headline true waiting list number but will be excluded from those figures measuring progress towards the national waiting time standards, or

  added to the true waiting list without an ASC. In this case the patients will be included in the figures measuring progress towards the waiting time standards, or

  removed from the waiting list because, for example, they no longer require treatment.

  Workforce

  

Staff Summary
 
 


Staff in post – all staff groups
Yes
 


Staff Turnover - all staff groups
No
Considering adding this information to future website releases. Will assess demand.


Medical and Dental
 
 


Staff in post
Yes
 


Vacancy survey
Yes
 


Junior doctors and dentists hours
Yes
 


Nursing and Midwifery
 
 


Staff in post
Yes
 


Vacancy survey
Yes
 


Agency usage
Yes
 


Bank usage
Yes
 


Agency v. Bank nurse usage
Yes
 


Professions Allied to Medicine (PAMs) (now known as Allied Health Professionals)
 
 


Staff in post
Yes
 


Vacancy survey
Yes

Housing

Ms Sandra White (Glasgow) (SNP): To ask the Scottish Executive, further to the answer to question S2W-10399 by Ms Margaret Curran on 14 September 2004, how many social rented houses have been completed in each local authority area in 2003-04.

Malcolm Chisholm: I have asked Angiolina Foster, Chief Executive of Communities Scotland to respond. Her response is as follows:

  Ministers have given a commitment to provide 18,000 new and improved homes for social rent and low cost home ownership in the 3 years up to 2006. The principal mechanism for funding this new affordable housing is the Scottish Executive Housing Investment Programme. The following table shows the number of new and improved housing completions made available through the Scottish Executive for social rent in 2003-04.

  Number of New & Improved Housing Completions Made Available Through the Scottish Executive for Social Rented Sector Housing (2003-04)

  

Unitary Authority
Total 2003-04


Aberdeenshire
125


Angus
73


Argyll & Bute
81


City of Aberdeen
68


City of Dundee
145


City of Edinburgh
199


City of Glasgow
1,338


Clackmannan
58


Dumfries & Galloway
128


East Ayrshire
2


East Dunbartonshire
4


East Lothian
30


East Renfrewshire
0


Falkirk
16


Fife
145


Highland
140


Inverclyde
87


Midlothian
27


Moray
2


North Ayrshire
78


North Lanarkshire
143


Orkney Islands
0


Perth & Kinross
148


Renfrewshire
121


Shetland Islands
2


South Ayrshire
42


South Lanarkshire
173


Stirling
61


The Scottish Borders
62


West Dunbartonshire
110


West Lothian
45


Western Islands
1



  Note: Figures include houses by housing associations and other suppliers for the social rented sector and do not include homes destined for low-cost home ownership or other forms of affordable housing.

  The number of completions in an individual year is largely determined by the nature of the projects approved for construction in previous years. Large or complex housing projects, especially when linked to a wider regeneration initiative, can often take over a year to be completed. In some instances, there is a time-lag in the recording of this data and these figures can therefore be subject to revision.

NHS Services

Colin Fox (Lothians) (SSP): To ask the Scottish Executive what approaches it has made to NHS Lothian on the implications for surgical services of Improving Care, Investing in Change 2004 .

Mr Andy Kerr: None. The current position is that NHS Lothian is undertaking a public consultation on the future of health services in Lothian. Once the consultation period ends, in November, it will be for NHS Lothian to take into account views and opinions expressed in shaping the future of health services in its area. Any proposals for major changes to services must come to me for prior approval.

NHS Services

Shona Robison (Dundee East) (SNP): To ask the Scottish Executive how many managed clinical networks were set up in the NHS in each year since 1998, broken down by (a) NHS board and (b) speciality.

Mr Andy Kerr: The date on which each Managed Clinical Network (MCN) was established is not available centrally.

  While the table below gives data on the (MCN) within each NHS Board, it should be noted that a number of the MCNs listed have not yet been accredited by NHS Quality Improvement Scotland as stated in the Clinical Governance Guidance for MCNs contained in HDL (2002) 69.

  It should also be noted that there are a number of national MCNs which include Scottish Muscle, Paediatric Epilepsy, Cleft Lip and Palate, Child Protection and Phototherapy; and that there are three Regional Cancer Networks covering Scotland.

  

NHS BOARD
MANAGED CLINICAL NETWORK


Argyll & Clyde

Coronary Heart Disease
Diabetes
Stroke


Ayrshire &Arran

Breast
Colorectal
Coronary Heart Disease
Diabetes
Epilepsy
Gynaecological Cancers
Head and Neck
Haematology
Lung
Palliative Care
Skin
Stroke
Upper Gastro Intestinal
Urology


Borders

Coronary Heart Disease
Diabetes
Palliative Care
Stroke


Dumfries & Galloway

Cardiac Services Evaluation
Coronary Heart Disease
Stroke
Diabetes


Fife 

Addictions
Coronary Heart Disease
Diabetes
Ear Nose and Throat
Learning Disabilities
Stroke


Forth Valley

Child Protection
Coronary Heart Disease
Cystic Fibrosis
Diabetes
Eating Disorders
Epilepsy
Learning Disability
Multiple Sclerosis
Palliative Care
Stroke


Grampian

Breast Cancer
Colorectal Cancer
Coronary Heart Disease
Diabetes
Ear, Nose and Throat
Lung Cancer
Ovarian Cancer
Stroke


Greater Glasgow

Coronary Heart Disease
Diabetes 
Epilepsy
Neurology Evaluation
Stroke


Highland

Community Hospitals (Stroke and Respiratory Receiving)
Coronary Heart Disease
Diabetes
Stroke


Lanarkshire

Coronary Heart Disease
Diabetes
Palliative Care
Neurology Evaluation
Stroke
Vascular Evaluation
Vascular Pump-priming


Lothian

Coronary Heart Disease
Diabetes
Stroke


Orkney 

Coronary Heart Disease
Diabetes 
Stroke


Shetland

Coronary Heart Disease
Diabetes
Stroke


Tayside

Addictions
Bone and Osteo-arthritis
Dementia
DiabNet Care for Children with Diabetes
Ear Nose and Throat
Epilepsy
Foot Service
Learning Disabilities
Orthodontic Services
Paediatric Gastroenterology 
Paediatric Neurology
National Neonatal Transport Services
Respiratory
Brain Injuries
Hepatitis C


Western Isles

Coronary Heart Disease
Diabetes
Stroke

NHS Staff

Shona Robison (Dundee East) (SNP): To ask the Scottish Executive what the professional development entitlement is for (a) doctors, (b) nurses, (c) allied health professionals and (d) scientific and professional staff.

Mr Andy Kerr: A new NHS Knowledge and Skills Framework (KSF) will be applied to all NHS jobs covered by the Agenda for Change Agreement which should be implemented on the 1 December 2004. The KSF will help staff identify their knowledge and skills requirements likely to be needed for future career steps and identify the development need to support that.

NHS Staff

Shona Robison (Dundee East) (SNP): To ask the Scottish Executive how many registrations of NHS nurses who have been working in Scotland have lapsed in each year since 1999, broken down by NHS board area.

Mr Andy Kerr: This information is not held centrally. The Nursing and Midwifery Council (NMC) has responsibility for the regulation of nurses, midwives and specialist community public health nurses in the UK and for maintaining a live register. The NMC do not record lapsed registrants.

NHS Staff

Shona Robison (Dundee East) (SNP): To ask the Scottish Executive how many (a) consultants, (b) GPs, (c) nurses and (d) other staff affected by Agenda for Change will receive protected salaries due to the implementation of the consultants’ contract, GP contract and Agenda for Change.

Mr Andy Kerr: a) SEHD is aware of five consultants so far who have received a protected salary as a result of the consultant contract.

  b) The great majority of general practitioners do not receive a salary but are independent, self-employed contractors. Under the terms of the new General Medical Services (GMS) contract, each GP practice receives a Global Sum payment as a contribution towards its costs, including staff and running costs, in delivering essential and additional services to patients. A protection mechanism (the Minimum Practice Income Guarantee – MPIG) ensures that a practice’s global sum payments will be no less than its previous income from fees and allowances for the comparable, equivalent terms. Approximately 94% of GP practices receive an MPIG.

  c) and d) the number of NHS staff on pay protection following the implementation of Agenda for Change will not be known until the process of matching and evaluating all NHS staff affected by the new system is complete.

Prescription Charges

Colin Fox (Lothians) (SSP): To ask the Scottish Executive how many pre-payment certificates were issued for NHS prescriptions last year.

Mr Andy Kerr: The following table shows the total number of prescription pre-payment certificates (PPCs) issued in 2003-04.

  

PPCs valid for 12 months
PPCs valid for 4 months 



 
45,992
103,210